Doctors warn of critical difference in cardiac arrest symptoms between men and women

Half of all people who have a cardiac arrest will feel symptoms in the 24 hours before, according to a new study – but the telltale signs are different for men than women.

A cardiac arrest, when the heart stops beating, is the most deadly form of heart condition, killing 90% of all those it strikes outside of a hospital.

This means there is an urgent need to better predict and prevent it. If more people are aware of the symptoms then they may visit a hospital before the cardiac arrest strikes.

For women, the most prominent symptom of an impending sudden cardiac arrest was shortness of breath, whereas men experienced chest pain, according to a new study from the Smidt Heart Institute at the Cedars-Sinai Medical Center in the US.

Smaller subgroups of both genders experienced palpitations, seizure-like activity and flu-like symptoms.

‘Harnessing warning symptoms to perform effective triage for those who need to make a 911 call could lead to early intervention and prevention of imminent death,’ said senior study author and sudden cardiac arrest expert Dr Sumeet Chugh.

‘Our findings could lead to a new paradigm for prevention of sudden cardiac death.’

The study, published in the journal Lancet Digital Health, found that half of individuals who experienced a sudden cardiac arrest also experienced a telling symptom 24 hours before their loss of heart function.

The team studied data from the ongoing Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO) Study in Ventura County, California, and the Oregon Sudden Unexpected Death Study (SUDS), based in Portland, Oregon.

‘It takes a village to do this work,’ said Dr Chugh.

‘We initiated the SUDS study 22 years ago and the PRESTO study eight years ago. These cohorts have provided invaluable lessons along the way.

‘Importantly, none of this work would have been possible without the partnership and support of first responders, medical examiners and the hospital systems that deliver care within these communities.’

The investigators evaluated the prevalence of individual symptoms and sets of symptoms prior to sudden cardiac arrest, then compared these findings to control groups that also sought emergency medical care.

Co-author Dr Eduardo Marbán said: ‘This is the first community-based study to evaluate the association of warning symptoms, or sets of symptoms, with imminent sudden cardiac arrest using a comparison group with EMS-documented symptoms recorded as part of routine emergency care.’

Such a study paves the way for additional prospective studies that will combine all symptoms with other features to enhance prediction of imminent sudden cardiac arrest.

Dr Chugh added: ‘Next we will supplement these key sex-specific warning symptoms with additional features – such as clinical profiles and biometric measures – for improved prediction of sudden cardiac arrest.’

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